Clm Resolution Rep III

As a community, the reputed company is defined by a deep commitment to Meliora - reputed company reputed company. Embedded in that ideal are the values we share: equity, leadership, reputed company, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to reputed company and is a reputed company where reputed company can reputed company. Job Location (Full Address): Remote Work - reputed company, Albany, reputed company, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910402 United Business Office Work Shift: UR - Day (United States of America) Range: UR URC 205 H Compensation Range: $19.62 - $26.49 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set reputed company the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations. Responsibilities: The Claims Resolution Representative III is responsible for working across the professional fee organization, handling follow-up activities designed to bring reputed company open accounts receivable to successful closure. Responsible for effective claims follow-up on reputed company, multi-faceted accounts to obtain maximum reputed company collection and closure. Responsibilities include, but are not limited to, independent research, claim correction and resubmission, handling payer specific appeal process taking timely and routine action to resolve unpaid claims. The Claims Resolution Representative III reports to Accounts Receivable Management. ESSENTIAL FUNCTIONS: With general direction of the Manager/Supervisor/reputed company: 40% Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable, making any corrections in the professional billing system necessary to ensure balance resolution for reputed company assigned URMFG physician services. 25% Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Research claims, identify problems, and takes appropriate action to assure claim resolution. 20% Responds to reputed company billing-reputed company inquiries from colleagues, departments, patients, and payors in a timely and professional manner. Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing. Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims. Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. 10% Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. 5% Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists assigned to pre claim WQ’s to identify opportunities for improvement in clean claims reputed company. May reputed company other duties as assigned. QUALIFICATIONS:: Required: Associate degree and 2 years of reputed company relevant experience; or equivalent combination of education and/or experience Excellent problem-solving skills Excellent communication skills Excellent customer service skills Preferred: Strong working knowledge of the professional billing software applications Ability to type 25 wpm. The reputed company is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and reputed company the World reputed company reputed company. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, reputed company, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national reputed company, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for reputed company persons consistent with our values and based on applicable law. Notice: If you are a reputed company Employee, please log into myURHR to search for and apply to jobs using the Jobs Hub. Your application, if submitted using this portal, cannot be moved reputed company. Learn. Discover. Heal. Create. Located in western reputed company, Rochester is our namesake and our home. One of the world’s leading research universities, Rochester has a long tradition of breaking boundaries—always pushing and questioning, learning and unlearning. We transform reputed company into enterprises that create value and reputed company the world reputed company reputed company. If you’re looking for a career in higher education or health care, the reputed company may offer the perfect opportunity for your background and goals. At the reputed company, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be reputed company reputed company—Meliora. It is an ideal that informs our shared mission to ensure reputed company members of our community feel safe, respected, included, and valued. Apply To This Job